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Crash of a Britten-Norman BN-2A-20 Islander in West Portal: 1 killed

Date & Time: Dec 8, 2018 at 0828 LT
Type of aircraft:
Operator:
Registration:
VH-OBL
Flight Phase:
Flight Type:
Survivors:
No
Site:
Schedule:
Hobart – Bathurst Harbour
MSN:
2035
YOM:
1986
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Circumstances:
The pilot departed Hobart Airport at 0748LT on a positioning flight to Bathurst Harbour, southwest Tasmania. En route, she encountered poor weather conditions and limited visibility when the airplane struck the slope of a mountain located in the Southwest National Park, some 32 km northeast of the intended destination. The wreckage was found few hours later in West Portal, about 100 meters below the summit. The pilot, sole on board, was killed.

Crash of a Rockwell Shrike Commander 500S near Hobart: 1 killed

Date & Time: Feb 19, 2004 at 1643 LT
Operator:
Registration:
VH-LST
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Hobart – Devonport
MSN:
500-3111
YOM:
1971
Location:
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
371
Captain / Total hours on type:
40.00
Circumstances:
The aircraft commenced taxying at Hobart for a Visual Flight Rules (VFR) ferry flight to Devonport. The pilot, who was the sole occupant, reported a departure time of 1643 to air traffic control, with an intention to climb to 8,500 ft and to fly a track of 319 degrees magnetic. Due to following traffic, the pilot was required to report leaving specific altitudes. At 1646, the pilot reported leaving 4,500 ft, and was advised that air traffic services were terminated. The acknowledgement of that call was the last communication heard from the pilot. At about 1800, the operator’s staff at Devonport advised the Hobart base that the aircraft had not arrived. The operator advised AusSAR and the Hobart air traffic control tower, and organised company search aircraft from both Hobart and Devonport. The non-flying occupant of the Hobart search aircraft sighted the wreckage at about 1930. Shortly after, a search and rescue helicopter arrived at the accident site. The pilot of the aircraft was found fatally injured in the wreckage. The wreckage was located 58 km from Hobart airport on a bearing of 320 degrees magnetic. Based on predictions of aircraft performance and the distance of the accident site from Hobart, the estimated time of the accident was 1656. There were no eyewitnesses to the accident. Aircraft flight profile The aircraft was not equipped with a flight data recorder or cockpit voice recorder, nor was it required to be. As such, and given that the aircraft was operating outside of radar coverage, there was no recorded flight profile information available. The pilot was not required to report cruising at 8,500 ft and there was no evidence to confirm that the aircraft had reached that altitude. However, based on the normal climb and cruise performance, forecast winds and the radio broadcasts made by the pilot, the aircraft should have reached an altitude of 8,500 ft approximately 35 km from Hobart at about 1651, which was 5 minutes prior to the estimated time of the accident at 1656.
Probable cause:
The trajectory analysis provided the ATSB with a high degree of confidence with respect to the aircraft altitude and speed at the time of the in-flight breakup. The aircraft’s speed could have readily accelerated to Vne during a rapid descent from the nominated cruise altitude of 8,500 ft to the break-up altitude of around 3,150 ft. At such a speed, a relatively small control input force or gusts encountered in the longitudinal (pitch) axis of the aircraft could have resulted in the symmetrical downward wing overloading and failure that occurred. There is no compelling evidence to support any one reason for the departure of the aircraft from the cruise altitude into a high speed dive type situation. However, there are a number of factors that provide some weight to the possibility of a flight upset related to operation of the autopilot. These factors include:
• The lack of any reference in the operations manual to the installation of a Bendix FCS-810 autopilot in LST and the lack of information in the operations manual on the operation of the FCS-810 autopilot
• The pilot’s relative inexperience in the operation of the particular autopilot system fitted to LST
• The operating characteristics of the autopilot system fitted to LST
• The illegible nature of the Aircraft Flight Manual supplement pertaining to the limitations and operating procedures for the autopilot system fitted to LST
• The autopilot controller pitch command wheel being found at the accident site in the maximum nose-down position
• Both elevator trim tabs being found at the accident site at or close to the maximum nose-down trim position. However, it is not possible to discount other explanations for the departure from cruise flight, including a runaway pitch-trim condition, pilot incapacitation, the effects of mountain waves and/or severe turbulence, or a combination of any of the above. On the evidence available to the investigation, it was not possible to conclusively determine the circumstances that led to the aircraft descending at speed to the altitude at which the in-flight breakup occurred.
Final Report:

Crash of a De Havilland DH.114 Heron 2D in Launceston

Date & Time: Aug 4, 1983
Type of aircraft:
Operator:
Registration:
VH-CLY
Survivors:
Yes
Schedule:
Hobart - Launceston
MSN:
14122
YOM:
1957
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
5
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
On final approach to Launceston Airport, the aircraft was misaligned and the crew decided to initiate a go-around procedure. Gear were retracted and flaps were partially raised when the airplane lost height and struck fences. It crash landed and came to rest on the runway. All seven occupants escaped with minor injuries and the aircraft was damaged beyond repair.

Crash of a Rockwell Aero Commander 685 in the Bass Strait: 2 killed

Date & Time: Jul 17, 1983 at 1505 LT
Operator:
Registration:
VH-WJC
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Hobart - Melbourne
MSN:
685-12005
YOM:
1972
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
2
Circumstances:
On 17 July 1983 the pilot of Rockwell (Aero Commander) 685 aircraft VH-WJC submitted a flight plan to the Hobart Briefing Office for a private category flight from Hobart to Moorabbin, tracking via Launceston and Wonthaggi. The plan indicated that the flight would be conducted under the Instrument Flight Rules (IFR) at Flight Level 120 (12 000 feet altitude on standard atmospheric pressure of 1013.2 millibars), with two persons on board. The flight plan showed that the aircraft had a fuel endurance of 220 minutes, and carried an Emergency Locator Beacon (ELB) and life jackets. There was no indication that a life raft was carried. The aircraft departed Hobart at 1352 hours and, thereafter, the pilot made the appropriate radio reports to Hobart Tower, Launceston Control and Launceston Tower. The flight apparently progressed normally until 1452 hours when the pilot advised Launceston Control, "Er Whiskey Juliet Charlie we seem to have been in trouble with er fuel here the red er warning light comes on and the gauge is down . . .".At 1454 hours the pilot transmitted a Mayday call, indicating that he was descending from Flight Level 120 on track to Bass (a position reporting point), present position was 85 nautical miles (nm) from Launceston and he would be making a controlled ditching. Launceston Control immediately initiated the Distress phase of the Search and Rescue procedures and advised the Melbourne Operational Control Centre (OCC). Further communications between the aircraft and Launceston Control indicated that the aircraft was continuing descent on track towards Wonthaggi. The last position report from the pilot, at 1500 hours, was 94 nm from Wonthaggi. The last recorded transmission from the aircraft was at 1501 hours when the pilot confirmed that there were two persons on board. There were no indications at any time from the pilot that the fuel supply had been exhausted or that either engine had failed. It was estimated that the aircraft ditched at about 1505 hours, at an approximate position of 81 nm from Wonthaggi on the planned track. No trace of the aircraft nor both occupants was found.
Probable cause:
Due to lack of evidences, the exact cause of the accident could not be determined.
Final Report:

Crash of a Rockwell Shrike Commander 500S off Hobart

Date & Time: Apr 27, 1981 at 1814 LT
Operator:
Registration:
VH-EXQ
Survivors:
Yes
Schedule:
Melbourne – Hobart
MSN:
500-1831-28
YOM:
1968
Location:
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
5
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
1925
Captain / Total hours on type:
77.00
Circumstances:
Due to industrial action, normal domestic airline services had been suspended. The pilot hired the aircraft to convey persons stranded by the strike between Hobart and Melbourne. He submitted a flight plan for the proposed return flight to Melbourne that nominated operations under the Instrument Flight Rules, although he did not hold an appropriate Instrument Rating. The flight to Melbourne was completed without known incident. After refuelling the aircraft and engaging five passengers, the return flight was commenced. A fare was paid by each passenger although the pilot did not hold either a Charter Licence or an appropriate pilot licence. There was considerable cloud in the vicinity of Hobart Airport which, at 1800 hours, was recorded as one okta stratus, base 800 feet; five oktas stratocumulus, base 3000 feet; five oktas altocumulus, base 11,000 feet. The surface wind was a light westerly, and the runway in use was Runway 30. There were rain showers in the area and the runway was wet. The end of daylight was at approximately 1748 hours. When the pilot of VH-EXQ contacted Hobart Tower at approximately 1800 hours, he reported on descent to 7000 feet and 50km from the airport. As the aircraft proceeded, the Aerodrome Controller cleared it for further descent in stages, to provide vertical separation from a preceding aircraft. The only Instrument Landing System (ILS) approach at Hobart Airport was aligned with Runway 12 and the tailwind for a landing in that direction was only two or three knots. In order to expedite their arrivals, the Aerodrome Controller offered the pilot s of both approaching aircraft the option of a straight-in ILS approach to Runway 12 instead of a circling approach to the into-wind Runway 30. Both pilots accepted. At 1803 hours, the preceding aircraft was cleared for an ILS approach. The pilot of VH-EXQ was then advised to expect the same clearance but, to ensure continued separation from the other aircraft, was instructed to make one circuit of the holding pattern at Tea Tree Locator, a navigational radio aid west of the airport. The pilot misunderstood this instruction and, on reaching Tea Tree at about 1805 hours, he continued towards the airport. At 1807 hours, the Aerodrome Controller cleared VH-EXQ for an ILS approach. The pilot acknowledged this instruction in the normal manner and did not advise that he had already commenced the approach. In descending towards the airport the pilot had maintained a high airspeed of nearly 200 knots. From overhead Tea Tree he could see the lights of the preceding aircraft and endeavoured to reduce his speed so as to maintain separation. As a result, the aircraft was still very high as it approached the runway. This was noted by the Aerodrome Controller and, at 1810 hours, he asked the pilot whether he would be able to land on Runway 12 or would prefer to make an approach for Runway 30. The pilot chose the latter and was cleared to a right base leg for Runway 30. The approach to Runway 12 was abandoned and the aircraft turned left onto a close right downwind leg for Runway 30. The landing gear, which had been extended, and the flaps, which had been set at 1/4 down, were not moved from these positions. The pilot reported that at some stage of the approach to Runway 30 he moved the throttles forward to increase power and maintain height. In response the aircraft yawed slightly to the right. Both propeller levers were then pushed fully forward, both throttles were fully opened and the mixture controls were checked in the full-rich position. The aircraft again swung to the right. Identifying this as evidence that the right engine had failed, and after checking from the tachometer that the right propeller was windmilling at about 1500 RPM, the pilot feathered the right propeller and selected the landing gear and flaps up. He believed that he carried out the feathering action at a height of about 300 feet and an airspeed of about 100 knots. At this time the aircraft was heading southwest, towards Single Hill (elevation 680 feet) on the shore of Frederick Henry Bay. The pilot reported that the aircraft would not maintain height or airspeed and he therefore turned left to avoid the hill. The wings were then held level until the aircraft touched down in the bay. After the aircraft turned right at a close base leg position, but then straightened on a southwesterly heading instead of continuing the turn onto final approach, the Aerodrome Controller asked the pilot to confirm that he was tracking for Runway 30. This transmission was not answered and the Aerodrome Controller again called the aircraft. The pilot then reported that he was having trouble with the right engine and he was going to feather. This transmission was made as the aircraft was approaching Single Hill, just before it turned left and descended from view. There were no further transmissions from the aircraft despite a number of calls by the Aerodrome Controller. The Distress Phase of Search and Rescue (SAR) procedures was declared at 1815 hours. The appropriate emergency services were alerted including a helicopter that was on standby for SAR operations. All six occupants were rescued while the aircraft sank and was lost.
Probable cause:
The probable cause of the accident was that, following an apparent loss of power by the right engine, the pilot did not operate the aircraft in the configuration and at the airspeed necessary for safe single-engine flight. The pilot's responses may have been Influenced by operating under Instrument Flight Rules conditions, for which he was not qualified. The cause of the reported loss of power by the right engine was not determined. The following defects were discovered:
- General mechanical wear in left engine,
- Left engine fuel injector system outside manufacturer's specifications,
- Slight timing fault in one magneto on right engine.
Final Report:

Crash of a Douglas C-47-DL off Hobart: 1 killed

Date & Time: Jan 12, 1956 at 0340 LT
Operator:
Registration:
VH-BZA
Flight Type:
Survivors:
Yes
Schedule:
Melbourne – Hobart
MSN:
4651
YOM:
1942
Location:
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Circumstances:
The crew was performing a cargo flight from Melbourne to Hobart, carrying a load of refrigeration equipment. While descending to Hobart, the crew passed through the clouds at 2,000 feet then completed a turn over the Frederick Henry Bay when the aircraft crashed into the bay about 13 km from the runway 30 threshold. The captain Peter Kemp was rescued while the copilot Alan Jay was killed.
Probable cause:
The pilot relied on inadequate external visual reference for determining the altitude and paid insufficient attention to the instruments. The irregular approach procedure carried out by the pilot in command deprived him of the opportunity to monitor the safe approach to the aerodrome through the correlation of time, height and position. This probably contributed to the accident.

Crash of a Douglas C-47A-20-DK off Hobart: 2 killed

Date & Time: Aug 8, 1951 at 2100 LT
Operator:
Registration:
VH-TAT
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Hobart – Melbourne
MSN:
13083
YOM:
1944
Location:
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
2
Circumstances:
Shortly after takeoff from Hobart Airport, while in initial climb, the crew started a turn at low height when the aircraft stalled and crashed into the Barilla Bay, less than 3 km from the airfield. Both crew members were killed.
Probable cause:
It was determined that the loss of lateral control during a turn at low altitude soon after takeoff was probably caused by the presence of ice on the aircraft surface.

Crash of a Douglas C-47-DL off Hobart: 25 killed

Date & Time: Mar 10, 1946 at 2055 LT
Type of aircraft:
Operator:
Registration:
VH-AET
Flight Phase:
Survivors:
No
Schedule:
Hobart – Melbourne
MSN:
6013
YOM:
1942
Location:
Country:
Region:
Crew on board:
4
Crew fatalities:
Pax on board:
21
Pax fatalities:
Other fatalities:
Total fatalities:
25
Captain / Total flying hours:
3500
Copilot / Total flying hours:
1400
Aircraft flight hours:
7477
Circumstances:
Two minutes after takeoff from Hobart-Cambridge Airport, while in initial climb, the aircraft went out of control, nosed down and crashed in the Derwent estuary, near the Seven Mile Beach. The aircraft was destroyed and no survivor was found among the 25 occupants.
Probable cause:
The exact cause of the accident could not be determined with certainty. However, it is believed that the captain inadvertently switched on the autopilot system in lieu of the fuel cross feed system. A forward movement on the control column was then noted and the aircraft plunged into the sea. At the time of the accident, the capacities and the performances of the captain were considered as reduced because he suffered of diabetes and was under influence of insulin, which could be considered as a contributory factor.